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Please help with high leak rate
#41
RE: Please help with high leak rate
Amazing difference.
Sleeprider
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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#42
RE: Please help with high leak rate
A comment about the "numerous chin straps" you've tried, Yankees123.  If they are the standard neoprene ones that wrap around the tip of the chin, they aren't really designed to work, especially the ones that are a simple linear strap.  Notice that the line between the tip of your chin and the point at the top back of your head farthest back from the tip of your chin passes almost directly through your jaw joint.  This means that essentially all the force just pushes your jaw into your jaw joint and almost none of it works to lift your jaw.  Try the Knightsbridge Dual Band chin strap.  As far I can tell it's the only one designed to actually work.  It lifts from below the jaw, and the two bands (one elastic, one non-elastic) allow you to adjust it to be very comfortable.  (It does cover more of your head that the standard neoprene chin straps, but for me it's worth it to prevent the mouth leaks.)
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#43
RE: Please help with high leak rate
Thanks for responding Leonardo dr.  I have tried that chin strap just recently.  I found it to be very uncomfortable and didn’t stop my leaks.
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#44
RE: Please help with high leak rate
In my journey to find a substitute for my full face mask the last two days I have been using the resmed n20 nasal mask with the setting on my aircurve set to pillows.It's so nice to have something that is much less bulk on your face.  I fit in a small size and you can see my Oscar data for the two nights.  
I know my AHI is very good but I have a few questions.  
Why is my tidal volume so low as compared to when I wear my f20?  Is this normal?  Also on 3/11 Oscar data,  it looks like I had a lot of areas of flow limitation as you can see from the isolated views. The mask is very comfortable and I tape my mouth and in the morning the tape is still on very well. I am getting leaks which I am totally unaware of but they are not in the excessive range I don't believe.  
I also notice that the graph of the flow rate,that the amplitude is definitely less than when I use my full face mask. Would it make any different in my data if I changed the setting to nasal and not pillows?
Do you recommend any changes I should be making?
Thanks.


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#45
RE: Please help with high leak rate
One more screenshot.


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#46
RE: Please help with high leak rate
Just wondering if anyone has any advice for me or can help me with my questions? Thanks
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#47
RE: Please help with high leak rate
The pillows setting is correct according to ResMed:

https://www.resmed.com/us/dam/documents/...er_eng.pdf

(Scroll down to the technical specs.)

Wish I knew the answers to your questions, but I don’t have the expertise. I hope an expert will be able to help you.
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#48
RE: Please help with high leak rate
Your tidal volume has not changed, but your leak rate through your mouth impairs the accuracy of the sensors in your machine. Tidal volume is simply the volume of expired air per breath in mL You can see on your recent charts, the flow rate attenuates as leaks increase. Your leaks approach, but don't exceed large leak flagging. Anyway, tidal volume is just being masked by the leak. Your AHI seems better with nasal therapy, and managing leaks is going to be an ongoing challenge. Looking back, your tidal volume on March 3 and March 10 is identical at 460 mL and your minute vent is higher with nasal. Tidal volume appears lower on March 11, but it is due to the leaks.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#49
RE: Please help with high leak rate
Thanks Sleeprider for that explanation.  Hard to believe I have mouth leaks when I wake up my mouth is still taped shut with the tape.  Maybe it’s a mask leak which I am completely unaware of.
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#50
RE: Please help with high leak rate
Mask leaks from the Dreamwear full face and F20 are very audible. Not so with the P30i/N30i. I’m convinced that you’re having the same trouble I did with those masks. Since you have better results from nasal breathing as I do also there is a way to primarily breath nasally with a full face mask. It was a happy accident so to speak for me as I needed one but a soft cervical collar will keep your mouth closed and you’ll breath 95% of the time through your nose. 

If the Dreamwear fullface wasn’t sealing properly either, go with the ResMed F30. The F30i has the same size nasal cushion as the N30i and leaked profusely whereas the F30 fits and seals beautifully every night. With a properly adjusted top strap, the F30 will IMHO solve your leak issue.

I tried everything under the sun to use nasal/pillow masks and your leak chart is identical to mine. The only thing left to try for you is lanolin. Put a very small amount on your nostrils and that may make everything seal. If that does not work, IMO, so you can move on to other things you should accept that pillow/nasal masks are not the masks for you. I know it’s a tough pill to swallow since they are so easy to put on but from personal experience your overall experience and quality of therapy will be much better. In the end getting proper therapy and waking up refreshed and staying that way all day is what it’s all about. It’s the reason we all strap these things on our heads. A clean, recently shaved, oil free face and a clean, oil free, tacky full face mask will, I’m convinced, do just that for you.
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